George D. Oreopoulos MD, MSc, FRCS(C), Vascular Surgeon, University Health Network; Assistant Professor, Department of Surgery, University of Toronto, Toronto, ON.

Aortic dissection is the most common vascular emergency involving the aorta. Aortic dissection may present with a variety of clinical features and must be considered in order to avoid delay in diagnosis. Early CT scanning allows for the diagnosis to be confirmed and for the extent of the dissection to be determined. While proximal dissections require early surgery to prevent fatal complications, the initial treatment of distal dissections remains medical therapy with surgery or endovascular therapies being reserved for medical failures or for patients who develop specific complications. Newer endovascular treatments may ultimately alter the initial approach to distal dissections although this remains an area of controversy.
Key words: aortic dissection, clinical presentation, medical therapy, endovascular treatment, malperfusion syndromes.